Common use of Case Information Clause in Contracts

Case Information. WCB Case No. [enter claimant’s WCB Case No., e.g., 12345678], date of accident/occupational disease [enter claimant’s date of accident/occupational disease, e.g., 10/01/1990], is established as compensable for injuries to the [enter all sites of injuries for this case, e.g., back]. The average weekly wage is $[enter AWW, e.g., $600.00]. The claimant has been classified with a permanent partial disability (PPD), and payments are continuing at the rate of $[enter CCP rate, e.g., $200.00] per week (CCP rate). WCL § 15(8) liability was previously established at [enter percentage of 15(8) reimbursement, e.g., 100] % reimbursement and the 104/260-week retention period has been satisfied. [repeat this paragraph for all claims included in the agreement and specify apportionment if applicable]

Case Information. WCB Case No. [enter claimant’s WCB Case No., e.g., 12345678897654321], date of accident/occupational disease [enter claimant’s date of accident/occupational disease, e.g., 10/01/199003/30/1996], is established as compensable for injuries to the [enter all sites of injuries for this case, e.g., backneck]. The average weekly wage is $[enter AWW, e.g., $600.00800.00]. The claimant has been classified with a permanent partial disability (PPD), and payments are continuing at the rate of $[enter CCP rate, e.g., $200.00150.00] per week (CCP rate). WCL § 15(8) liability was previously established at [enter percentage of 15(8) reimbursement, e.g., 100] % reimbursement and the 104/260-week retention period has been satisfied. [repeat this paragraph for all claims included in the agreement and specify apportionment if applicable]